Health Rounds: Weight gain from various antidepressants varies slightly
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By Nancy Lapid
July 2 (Reuters) -Hello Health Rounds Readers! Antidepressants have long been associated with weight gain, but today we have a study that finds little difference among a wide variety of the drugs. We also cover a study that suggests shingles vaccines may be heart protective and a potential advance to improve testing for sleep disorders.
Health Rounds will be off for the July 4 U.S. holiday and back with important medical studies and advances next week.
Weight gain from antidepressants varies only slightly
Weight gain after starting treatment with antidepressants isn’t likely to vary much depending on the drug, according to a report published on Monday in Annals of Internal Medicine.
Among the eight antidepressants studied, bupropion (Wellbutrin) was consistently associated with the least weight gain, researchers said.
However, only small differences in weight changes were likely among patients taking any of the drugs, they said.
The researchers emulated a randomized trial to compare the drugs using health records of more than 183,000 adults who were starting treatment with either bupropion, sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), venlafaxine (Effexor), paroxetine (Paxil), or duloxetine (Cymbalta).
Zoloft - the most commonly prescribed first-line drug used by 20% of participants - was associated with an average gain of nearly 0.5 pounds (0.2 kilograms) after six months.
Users of Lexapro, Paxil and Cymbalta gained an average of 0.7 to 0.9 pounds (0.3 to 0.4 kilograms) more than those on Zoloft after 6 months, and were 10% to 15% more likely to have gained at least 5% of their baseline weight.
Wellbutrin users gained about half a pound less on average than Zoloft users, and they were 15% less likely to gain at least 5% of their baseline weight.
The effect of Prozac use on weight change was similar to that of Zoloft.
“Clinicians and patients could consider these differences when making decisions about specific antidepressants, especially given the complex relationships of obesity and depression with health, quality of life, and stigma,” the researchers said.
Shingles vaccine linked with cardiovascular benefits
Shingles vaccines may have the added benefit of protecting against strokes and heart attacks, a new study suggests.
Researchers compared 27,093 adults vaccinated against herpes zoster virus with five times as many similar people who had not been vaccinated. During five years of follow-up, rates of stroke were 1.6% among those who were vaccinated versus 2.2% for those who did not get the shingles shot. Rates of heart attack were 1.3% vs 1.8%, respectively.
The study was not a randomized trial and so cannot prove the vaccine actually prevented any cardiovascular events.
Everyone in the study had received the earliest shingles vaccine, Zostavax from Merck & Co MRK.N, which is no longer on the U.S. market.
Shingrix, the currently available vaccine from GSK GSK.L, is superior to the earlier shot at preventing shingles and recommended in the United States for all adults age 50 and older and for younger adults who are or will be at increased risk for shingles due to immunodeficiency or immunosuppression, the authors note in a report published in the American Journal of Preventive Medicine.
The benefits of the older Merck vaccine for lowering stroke and heart attack risks were greatest in people with diabetes, but patients with other conditions, including high blood pressure, chronic obstructive lung diseases, high cholesterol, or obesity, also had reductions in risk, the researchers found.
The researchers called for similar studies on the effect of Shingrix on heart attack and stroke, but added that these results may be relevant in parts of the world where Zostavax remains available.
Monitoring sleep with a single ECG lead
Artificial intelligence combined with just a single electrocardiography lead could eventually replace the multiple awkward wires on the head and chest currently used for diagnosing sleep disorders, researchers say.
“Our method achieves expert-level agreement with the gold-standard polysomnography without the need for expensive and cumbersome equipment and a clinician to score the test,” study leader Bhavin Sheth of the University of Houston said in a statement.
“This advancement... paves the way for more accessible, cost-effective sleep studies,” Sheth said.
The electrocardiography-based AI model was trained on data from 3,000 children and adults and then tested on data from an additional 1,000 participants, according to a report in Computers in Biology and Medicine.
Previously, sleep monitoring methods that did not include brain monitoring with electroencephalography had yielded “suboptimal” results, suggesting that EEG would always be necessary, the researchers said.
The new results challenge that notion, they added.
“Our findings establish that electrocardiography-based automated sleep staging” – or, cardiosomnography – “can achieve comparable performance to polysomnography,” they concluded.
Reporting by Nancy Lapid; Editing by Bill Berkrot
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